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Silently waiting to heal

Experiences among women living with urinary incontinence in northwest Ethiopia

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Abstract

Introduction and hypothesis

The aim of this study was to gain in-depth knowledge of women suffering from urinary incontinence (UI) in rural and semiurban settings in Ethiopia.

Methods

A qualitative study based on semistructured in-depth interviews with 26 informants, 18 of whom were women experiencing the symptom of urinary leakage. The study was conducted in the Amhara Region of northwest Ethiopia and was part of the Dabat Incontinence and Prolapse (DABINCOP) study.

Results

Limited access to water, soap, pads, and spare clothes characterized daily management of the symptom. The consequences for marital relationships and social life were of great concern to the informants. Shame, embarrassment, and fear of being discriminated against led to huge efforts to hide the leakage. Among informants who were not able to hide it, humiliating comments and discriminatory behavior were commonly experienced, sometimes leading to divorce and self-isolation. Women who disclosed their symptom usually had a person who supported them. Women with UI regarded it as unnatural and uncommon. Most took no action to improve the situation, as they saw no options for help.

Conclusions

Several circumstances limited the opportunities available to women to keep themselves clean, disclose the problem to others, and access health information and health-care facilities. In order to understand how women in this setting practically handled, perceived, and experienced living with UI, it was essential to address contextualized and sociocultural dimensions related to the symptom.

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Abbreviations

DABINCOP:

Dabat Incontinence and Prolapse Study

UI:

Urinary Incontinence

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Acknowledgements

The authors thank all study informants, especially the women who suffer from urinary incontinence who shared their experiences with us. We thank Professor Yigzaw Kebede (PI of the DABINCOP study) and the rest of the engaged research team at the University of Gondar – Professor Getu Degu, Dr. Berihun Megabiaw, Dr. Mulatu Adefris and Tesfahun Melese – for close and valuable collaboration throughout the process. Sincere appreciation goes to Hanna Abebe, the research collaborator, for vital assistance throughout the fieldwork period. We also thank Hibste Mekonnen and staff at the Department of Social Anthropology at the University of Gondar for valuable assistance and collaboration throughout the data collection period.

Funding

The Western Norway Regional Health Authority and Nordic Urogynecological Association.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Centre for International Health, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway

    Janne L. Gjerde

  2. Research Group for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway

    Guri Rortveit

  3. Research Unit for General Practice, Uni Health, Uni Research, Bergen, Norway

    Guri Rortveit

  4. Women and Health Alliance (WAHA) International, Gondar Fistula Center, University of Gondar, Gondar, Ethiopia

    Mulu Muleta

  5. Department of Public Health and Primary Health Care, Center for International Health, University of Bergen, Bergen, Norway

    Astrid Blystad

Authors
  1. Janne L. Gjerde
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  2. Guri Rortveit
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  3. Mulu Muleta
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  4. Astrid Blystad
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Corresponding author

Correspondence to Janne L. Gjerde.

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Gjerde, J.L., Rortveit, G., Muleta, M. et al. Silently waiting to heal. Int Urogynecol J 24, 953–958 (2013). https://doi.org/10.1007/s00192-012-1951-4

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  • DOI: https://doi.org/10.1007/s00192-012-1951-4

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